Ragsdale v. Turnock

Decision Date27 November 1985
Docket NumberNo. 85 C 6011.,85 C 6011.
Citation625 F. Supp. 1212
PartiesRichard M. RAGSDALE, M.D., et al., Plaintiffs, v. Bernard J. TURNOCK, et al., Defendants.
CourtU.S. District Court — Northern District of Illinois


Alan Gilbert, Susan M. Kornfield, Sonnenschein, Carlin, Nath & Rosenthal, Colleen K. Connell, Roger Baldwin Foundation of ACLU, Inc., Chicago, Ill., for plaintiffs.

Randolph T. Kemmer, Asst. State's Atty., Chicago, Ill., for Richard M. Daley.

Kathleen T. Kreisel, Gladys M. Stevens, Asst. Attys. Gen., Chicago, Ill., for other defendants.


NORDBERG, District Judge.

Plaintiffs bring this action against defendants pursuant to 42 U.S.C. §§ 1983, 1988 and 28 U.S.C. §§ 2201, 2202, seeking declaratory and injunctive relief. Plaintiffs challenge the constitutionality of three Illinois statutes, and the regulations thereunder, which, plaintiffs contend, form a scheme that in effect requires all abortions to be performed in a hospital or its functional equivalent. Plaintiffs charge that this scheme violates the equal protection rights of Illinois physicians who perform or desire to perform abortions, and the privacy rights of Illinois women who desire or may desire to obtain an abortion.

This matter is now before the court on the motions of plaintiffs to certify two plaintiff classes and one defendant class, and for a preliminary injunction against defendants. The plaintiffs have moved the court to maintain the following classes: (1) a plaintiff class of "all duly licensed physicians and surgeons performing or desiring to perform pregnancy terminations in Illinois," represented by named plaintiff, Dr. Richard M. Ragsdale; (2) a plaintiff class of "all women in the state of Illinois of child-bearing age who desire or may desire an abortion sometime in the future," represented by named plaintiffs Sarah Roe and Margaret Moe; and (3) a defendant class of "the State's Attorneys for all of the counties of the state of Illinois," represented by named defendant, Richard M. Daley. The plaintiffs have also moved the court to enjoin defendants from enforcing, in derogation of a physician's right to perform, and a woman's right to obtain, first and early second trimester abortions, three Illinois statutes: (1) Section 16(1) of the Illinois Medical Practice Act ("MPA"), Ill.Rev. Stat. ch. 111, para. 4433(1); (2) the Ambulatory Surgical Treatment Center Act of Illinois ("ASTCA"), Ill.Rev.Stat. ch. 111½, para. 157-8.1 — 157-8.16, and the regulations promulgated thereunder; and (3) the Illinois Health Facilities Planning Act ("HFPA"), Ill.Rev.Stat. ch. 111½, para. 1151-1168, and the regulations promulgated thereunder.

The court has reviewed the pleadings of the parties dealing with the class certification motion. The court held a hearing on the motion for preliminary injunction on November 18-22 and 26, 1985. The court has reviewed the pleadings dealing with the preliminary injunction motion, and has heard the opening statements and closing arguments of counsel and the testimony of witnesses. The court has considered all the evidence presented, including the depositions of several witnesses who did not testify at the hearing. The court has drawn reasonable inferences from this evidence, and has evaluated the legal arguments presented by the parties. In judging the credibility of each witness and the weight to be given the testimony of each, the court has taken into account for each witness the intelligence, ability and opportunity to observe, the age, the memory, the manner while testifying, any interest, bias, or prejudice the witness may have, and the reasonableness of the testimony considered in the light of all the evidence in the case. The court has reviewed its extensive hearing notes and its references concerning credibility.

Based on all of the evidence and legal arguments presented, and for the reasons set forth below, the court grants, with some modification, plaintiffs' motion for certification of the three classes, and the court grants plaintiffs' motion for a preliminary injunction. A preliminary consideration of the challenged statutes and regulations, and of the facts, will greatly aid in the discussion of both motions. Therefore, the court now turns to the statutes and regulations, and to the facts.

I. The Challenged Statutes and Regulations

The statutes and regulations which plaintiffs challenge in this action present an unusual mixture of abortion-specific and general provisions.1 First, section 16 of the MPA generally provides the grounds upon which the IDPH may revoke or suspend the medical license of any person. However, subsection (1), the only portion of section 16 which plaintiffs challenge, is abortion-specific. Under subsection (1), the IDPH may revoke or suspend the license of any physician who performs an "elective abortion" in any place other than an ASTC, a hospital, or a facility run by the state, the federal government, or a state university or college. Essentially, section 16(1) prohibits physicians from performing even one abortion in their offices, and requires physicians who wish to provide abortion services in non-hospital environments to comply with the ASTCA and the HFPA.

The ASTCA defines what an ASTC is and provides for the licensure of all ASTCs. Section 3 of the ASTCA defines an ASTC as "any institution, place or building devoted primarily to the maintenance and operation of facilities for the performance of surgical procedures or any facility in which a medical or surgical procedure is utilized to terminate a pregnancy, irrespective of whether the facility is devoted primarily to this purpose." Thus, the ASTCA applies generally to all ASTCs devoted primarily to the performance of surgical procedures, regardless of the specific procedure performed, while at the same time the ASTCA singles out, for more strict regulation, facilities at which abortions are performed. The remainder of the ASTCA concerns, for the most part, the requirements and the procedure for obtaining an ASTC license. One other provision of the ASTCA deals specifically with abortion, and that is section 6.1, which requires any corporation operating an ASTC devoted primarily to providing facilities for abortion to have a physician, who is licensed to practice medicine in all of its branches and is actively engaged in the practice of medicine at the ASTC, on the ASTC's board of directors as a condition to licensure of the ASTC.

The regulations promulgated pursuant to the ASTCA are comprehensive and detailed. They cover all aspects of the provision of abortion services, from personnel policies to physical plant requirements. Many of the regulations are abortion-specific. An entire section of the regulations, Subpart G, is abortion-specific. The regulations in subpart G include a prohibition upon the performance of abortions after the first trimester and reporting requirements for each abortion performed in an ASTC.

The physical plant requirements in the regulations cover building design, construction standards, physical requirements and mechanical and electrical systems. In effect, they require ASTCs to be the functional equivalent of small hospitals.2 These regulations include, but are not limited to, the following:

(a) Regulation 205.1320(a), requires an ASTC to be "identifiably separate" from other medical facilities and functions.
(b) Regulation 205.1330, requires anyone seeking to build or substantially remodel an ASTC to submit work plans to the state for prior approval. These work plans include architectural drawings, structural drawings, and mechanical drawings (which include drawings of the heating, cooling, ventilation, plumbing, drainage, standpipe and electrical systems).
(c) Regulation 205.1360(a), requires that an examination room be at least 80 square feet in size.
(d) Regulation 205.1360(b), requires that a procedure room have a minimum clear area of 250 square feet.
(e) Regulation 205.1370(a), requires an ambulatory surgical treatment center to have a "control station" located to permit "visual surveillance of all traffic which enters the operating suite".
(f) Regulation 205.1370(k), requires that "staff and personnel facilities be provided for male and female personnel," including a lounge, lockers, separate toilets, and space for changing clothes.
(g) Regulation 205.1370(n), requires a separate janitorial closet exclusively for the surgical suite.
(h) Section 205.1380, requires an ambulatory surgical treatment center to establish a "diagnostic facility" equipped to perform diagnostic tests far more elaborate and complex than those performed during the course of a pregnancy termination.
(i) Regulation 205.1400 regulates the size of doors and halls to require that some corridors be at least 8 feet in width and that doors to procedure rooms be at least 3 feet 8 inches wide. These dimensions parallel the requirements for hospital corridors.
(j) Section 205.1540 regulates the air conditioning, heating, and ventilation systems to require (a) specific filter efficiencies and (b) air flow systems "balanced" to comply with the detailed ventilation and pressure relationships established by the regulation. Different pressure relationships and air change requirements are specified for the following areas: (1) the procedure room, (2) the examination area, (3) the recovery room, (4) the instrument cleaning room, (5) the toilet room, (6) the janitors' closet, (7) the linen and trash area, (8) the anesthesia storage area, (9) the equipment storage area, (10) the clean linen and storage area, (11) the soiled linen storage area, (12) the laboratory area, and (13) miscellaneous other areas.

As can be seen, these regulations are extremely detailed. The regulations, without question, cause abortion providers to incur great construction or renovation costs.

The HFPA requires all "health Care facilities," which includes all ASTCs, to obtain a "permit," or certificate...

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9 cases
  • Ragsdale v. Turnock
    • United States
    • U.S. Court of Appeals — Seventh Circuit
    • August 12, 1988
    ...Court cases. This case comes to us on appeal from the district court's grant of plaintiffs' motion for a preliminary injunction. 625 F.Supp. 1212 (N.D.Ill.1985). Because we believe certain of the claims are moot, we vacate in part. In most respects, however, we affirm the preliminary A. Sta......
  • A Woman's Choice-East Side Women's Clinic v. Newman
    • United States
    • U.S. District Court — Southern District of Indiana
    • November 9, 1995
    ...law and actual practices today are insufficient to ensure that women make informed and thoughtful decisions. See Ragsdale v. Turnock, 625 F.Supp. 1212, 1231 (N.D.Ill.1985) (in balancing harms at preliminary injunction stage, court could consider fact that other existing laws would remain in......
  • Ragsdale v. Turnock
    • United States
    • U.S. Court of Appeals — Seventh Circuit
    • August 20, 1991
    ...Planning Act ("HFPA"), IIl.Rev.Stat. ch. 111 1/2, paras. 1151-1168, and the regulations promulgated thereunder." Ragsdale v. Turnock, 625 F.Supp. 1212, 1215 (N.D.Ill.1985). "Essentially, section 16(1) [of the MPA] prohibits physicians from performing even one abortion in their offices, and ......
  • Sherman v. Township High School Dist. 214
    • United States
    • U.S. District Court — Northern District of Illinois
    • March 28, 2008
    ...the court to the heightened due process concerns associated with the certification of a defendant class. See. Ragsdale v. Turnock, 625 F.Supp. 1212, 1223 (N.D.Ill. 1985). The court appreciates that the potential for binding absent defendants to an adverse ruling requires it to pay close att......
  • Request a trial to view additional results

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